Tuesday, December 15, 2015

Stopping tooth decay wihtout a drill

A
University of Sydney study has revealed that tooth decay (dental
caries) can be stopped, reversed, and prevented without the need for the
traditional 'fill and drill' approach that has dominated dental care
for decades.

The results of the seven year study, published today in Community Dentistry and Oral Epidemiology, found that the need for fillings was reduced by 30 to 50 per cent through preventative oral care.

"It's
unnecessary for patients to have fillings because they're not required
in many cases of dental decay," said the study's lead author,
Associate Professor Wendell Evans of the University of Sydney. "This
research signals the need for a major shift in the way tooth decay is
managed by dentists -- dental practice in Australia needs to change.
Our study shows that a preventative approach has major benefits
compared to current practice.

"For a long time it was believed
that tooth decay was a rapidly progressive phenomenon and the best way
to manage it was to identify early decay and remove it immediately in
order to prevent a tooth surface from breaking up into cavities. After
removing the decay, the affected tooth is then restored with a filling
material -- this process is sometimes referred to as 'drilling and
filling'.

"However, 50 years of research studies have shown that
decay is not always progressive and develops more slowly than was
previously believed. For example, it takes an average of four to eight
years for decay to progress from the tooth's outer layer (enamel) to
the inner layer (dentine).

"That is plenty of time for the decay to be detected and treated before it becomes a cavity and requires a filling."

Professor Wendell Evans and his team developed the Caries Management
System (CMS) -- a set of protocols which cover the assessment of decay
risk, the interpretation of dental X-rays, and specific treatment of
early decay (decay that is not yet a cavity).

The CMS treatment 'no-drill' involves four aspects: 1. Application of high concentration fluoride varnish by dentists to the sites of early decay 2. Attention to home tooth brushing skills 3. Restriction of between-meal snacks and beverages containing added sugar 4. Risk-specific monitoring.M/ul> "The CMS was first tested on high risk patients at Westmead Hospital with great success," said Professor Evans. "It showed that early decay could be stopped and reversed and that the need for drilling and filling was reduced dramatically. "A tooth should be only be drilled and filled where an actual hole-in-the-tooth (cavity) is already evident," he said.
The CMS treatment was then tested in general dental practices in New
South Wales and Australian Capital Territory. The Monitor Practice
Program (MPP), funded by the National Health and Medical Research
Council of Australia (NHMRC), confirmed that after seven years, decay
risk was substantially reduced among the CMS patients and their need for
fillings was reduced by 30 to 50 per cent compared to the control
group. "The reduced decay risk and reduced need for fillings was
understandably welcomed by patients," Professor Evans said. "However,
patients play an important role in their treatment. This treatment will
need a partnership between dentists and patients to be most
successful."

The white
patches are signs of early decay that can be stopped and reversed
before they become cavities (brown patch on tooth on the right).

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About Me

Martin Jablow DMD, is America's Dental Technology Coach. He practices general dentistry in a group setting in Woodbridge, NJ. Dr. Jablow promotes the use of technology in the dental office to improve efficiency and patient care. He lectures and writes articles on the use of technology to enhance the practice of dentistry. Dr. Jablow can be reached by email at marty at dentaltechnologycoach dot com